The Overall Objective : Effect of clomiphene citrate for prevention of premature LH surge in infertile women with poly cystic ovary syndrome undergoing intra uterine insemination(IUI).
Specific objectives: Compare the number of mature follicles , endometrial thickness ,pregnancy rate ,miscarriage rate and ongoing pregnancy rate in infertile women undergoing intra uterine insemination( IUI ), with receiving clomiphene citrate and control group.
Material and method: According to consult with statistics, 162 patients were divided to 2 groups, case and control .Patients with history of at least one year infertility ,who came to infertility clinic of mother and child hospital of shiraz with a history of clomiphene citrate resistance for 3 cycles were randomized and divided to two groups of 81 patients. After taking testimonial form , study was started. In this study 162 patients who had 2 or more including factors for ESHRE criteria for polycystic ovary syndrome with a history of at least one year infertility and 3 cycles clomiphene citrate resisitance who were candided for IUI, were divided to two groups randomaly due to table of random statistics numbers . (ESHRE/ASRM criteria for poly cystic ovary syndrome :chronic anovulation ,clinical or biochemical evidence of androgen excess and polycystic appearing ovaries on trans vaginal sonography )complications such as probability of OHSS, no response to gonadotropin therapy or not completing the course of treatment ,are the most excluding criteria.During study On the third day of the menstrual cycle , a basal vaginal sonography and a blood sample for hormonal assays were performed .Recombinal FSH (Gonal –F –serono) was injected subcutaneosly in a dosage of 75 IU/day from the 3rd day of the cycle to the day of the HCG injection those who were assigned to clomiphene citrate group ,receive 150 mg/day of clomiphene citrate (REZA K –Tehran) from the 8th to the they of HCG injection and those who were assigned to control group ,received nothing except r-Fsh.. Transvaginal sonography will be performed on the day of 11th of the cycle ,and rFSH will be contined till at least two dominant follicle with size of >18 mm will be seen then 10000IU of HCG will be injected intramusculary if serum E2 was <2000 pg/ml. The Endometrial thickness(ET) and serum LH, will be measured at the same day of hcg injection . Intra uterin insemination (IUI) Will be performed 36 hours after HCG administration. And B.HCG will be checked if the patient experience one week missed period . But pregnancy will be documented by transvaginal sonography at 6-7 weeks of gestation. And then data analysis will be done .At last 2 groups of case and control will be compared by number of mature follicles ,endometrial thickness, estradiol level on the day of HCG injection , premature LH surge (serum LH>10 IU /ML) chemical and clinical pregnancy rate,and abortion rate.